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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

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Cardiac resynchronization therapy in congenital heart disease

Jan Janoušek1, Peter Kubuš2

  • 1Children's Heart Centre, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V úvalu 84, 15006, Prague, Czech Republic. jan.janousek@fnmotol.cz.

Herzschrittmachertherapie & Elektrophysiologie
|May 27, 2016
PubMed

Insights

Cardiac resynchronization therapy (CRT) shows promise for congenital heart disease (CHD) patients. Efficacy in CHD depends on systemic ventricle anatomy, with best outcomes in those with systemic left ventricles receiving CRT after conventional pacing.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Cardiac resynchronization therapy (CRT) is effective for heart failure in adults with cardiomyopathy.
  • Limited data exists on CRT efficacy in patients with congenital heart disease (CHD).
  • CHD presents unique anatomical and functional challenges for CRT implantation.

Purpose of the Study:

  • To review the efficacy and implantation considerations of CRT in patients with CHD.
  • To highlight the importance of systemic ventricle anatomy in CRT outcomes for CHD.
  • To reference expert consensus guidelines on CRT in adult CHD.

Main Methods:

  • Review of existing literature on CRT in CHD.
  • Analysis of factors influencing CRT efficacy based on systemic ventricle anatomy.
  • Discussion of prevailing implantation techniques (thoracotomy, hybrid).

Main Results:

  • CRT efficacy in CHD appears dependent on systemic ventricle anatomy.
  • Best outcomes were observed in patients with a systemic left ventricle upgraded from conventional pacing.
  • Implantation techniques vary due to CHD structural heterogeneity.

Conclusions:

  • CRT may be a viable option for select CHD patients.
  • Systemic ventricle anatomy is a critical determinant of CRT success in CHD.
  • Further research is needed to optimize CRT in the diverse CHD population.

Keywords:
Biventricular pacemakers, artificialCardiomyopathyDyssynchronyHeart failurePrognosis

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